Ch 13 Neurocognitive Disorders

Question 1

Neurocognitive disorder

Answer 1

Temporary transient or permanent brain malfunctions triggered by changes in brain structure or biochemical processes result in impaired thinking memory or perception changes in behavior consciousness and emotional stability. Severe injury to the front regions of the brain display impulsive behavior including saying or doing things without thinking

Question 2

Major neurocognitive disorder

Answer 2

Condition involving significant decline in independent living skills and one or more areas of cognitive functioning. Shows significant decline in both of the following: one or more areas of cognitive functioning involving attention and focus decision making and judgment language learning and memory visual perception or social understanding, and the ability to independently meet the demands of daily livingmust involve a decline from higher levels of functioning

Question 3

Dementia major cognitive disorder

Answer 3

Decline in mental functioning and self help skills from a major neurocognitive disorder. Condition with symptoms involving deterioration in cognition and independent functioning. May forget names of significant others are past events may display difficulties with problem-solving and impulse control. Agitation due to confusion or frustration is common. typically has a gradual onset followed by continuing cognitive decline. Age is the strongest risk factor. The longer a person lives the greater the chance of developing dementia. 15% over 70. Because women live longer they are more likely to develop dementia

Question 4

Mild cognitive disorder

Answer 4

Minus the Klein and at least one major cognitive area. Degree is more subtle than in major. Often able to participate in normal activities but may require extra time or effort for complex tax. Accommodations to maintain independence may be required such as someone to manage finances but overall independent functioning is not compromised. Maybe an intermediate stage between normal aging and major neurocognitive disorder or dementia

Question 5

Delirium

Answer 5

Acute state of confusion involving diminished awareness disorientation and impaired attentional skills. Can be caused by exposure to toxins or medication or from alcohol and drug intoxication with drawl. Cora characteristics differ from mild in major neurocognitive disorder: disturbances in awareness and difficulty focusing maintaining or shifting attention as well as abrupt onset and fluctuating course. Develops over a period of several hours or days can be mild or severe can be BRIEFR last for several months. Cognitive difficulties include confusion regarding where they are or time of day. Wondering attention disorganized thinking and rambling irrelevant or incoherent speech may be present. May also have psychotic symptoms.symptoms can range from agitation and combativeness too drowsy unresponsive behavior.

Question 6

Neurodegeneration

Answer 6

A progressive brain damage due to neurochemical abnormalities and the death of brain cells such as in Alzheimer’s. They show a decline in function rather than improvement in contrast to stroke or Trumatic brain injury or substance-abuse. Can be a cause of neurocognitive disorder’s. Nero degenerative disorders include Elsheimer’s disease, dementia with Lewy bodies,Parkinson’s disease, Huntington’s disease, frontotemporal lobar degeneration, Aids dementia complex

Question 7

Event causes of neurocognitive disorder’s

Answer 7

I Seemic stroke, hemorrhagic stroke, Trumatic brain injury, substance-abuse

Question 8

Medically induced coma

Answer 8

It deliberately and just state of deep sedation that allows the brain to reset and he’ll

Question 9

Trumatic brain injury

Answer 9

A physical and or internal injury to the brain. Degree of impairment in corset recovery very significantly. 1.7 million people for you and care for head injury, most common in young. 2% of the population has a disability related to Trumatic brain injury. Head injury contributes to one third of injury related deaths. Diagnosis requires persistent cognitive impairment due to the injury and that the person had experienced loss of consciousness amnesia disorientation or confusing following the event or received and are logical test the document to bring dysfunction. Can be temporary or permanent mild to severe.

Question 10

Talked and die syndrome

Answer 10

A blow to the head can cause an unrecognized injury such as read in between the snow in the brain resulting in rapid and unexpected death.

Question 11

Symptoms of Trumatic brain injury

Answer 11

Depend on the severity of injury and area of brain injured. Also very with persons age. Headaches disorientation and confusion and memory loss deficits in attention or concentration fatigue and irritability as well as emotional and behavioral changes. Often sleep difficulties and emotionally symptoms such as depression, anxiety, irritability or apathy also affect recovery.

Question 12

Concussion

Answer 12

Trauma induced changes in brain functioning, subtle changes due to damage of neurons. typically caused by a blow to the head. Most common form of Trumatic brain injury. Injury affects functioning of the neurons and causes this orientation or loss of consciousness. Headache dizziness nausea impair coordination and sensitivity to light. Can last a few weeks and sometimes much longer. Amnesia free events prior to a concussion appears to be a strong predictor of the severity of the impairment following a concussion. 4 million per year due to competitive sports and recreational activities. Have to go unreported.

Question 13

Cerebral contusion

Answer 13

Bruising of the brain often resulting from the blow that causes the brain to forcefully strike the skull. Unlike disruption in cellular functioning seen in the concussion, contusions involve actual tissue damage in the areas bruised. Similar symptoms to concussion. Often brings reoccurs both of the side impact on the opposite side of the skull.

Question 14

Cerebral laceration

Answer 14

Open heaven Sharee and which brain tissue was torn pierced or rupture. Usually from the school fracture or an object that has penetrated the scope. As with a contusion damage is localized and immediate medical care focuses on reduce bleeding and preventing swelling.

Question 15

Chronic traumatic encephalopathy CTE

Answer 15

Progressive degenerative condition diagnosed when Autopsy the reveals diffuse fuse brain damage resulting from ongoing head trauma. A person who have multiple episodes of head injury such as athletes or the military. It’s associated with psychological symptoms such as depression poor impulse control and increased risk of dementia it’s in four stages. Progresses slowly over decades eventually resulting in dementia

Question 16

Stage one of CTE

Answer 16

Headache and loss of attention and concentration

Question 17

Stage 2CTE

Answer 17

Depression, explosive outburst, and short term memory loss

Question 18

Stage III CTE

Answer 18

Cognitive impairment, including difficulty with planning and impulse control

Question 19

Stage four of CTE

Answer 19

Dementia, word finding difficulty, and aggression

Question 20

Vascular neurocognitive disorder’s

Answer 20

Condition involving decline in cognitive skills due to reduced blood flow to the brain. Can result from a one time cardiovascular event such as the stroke or from unnoticed I’m going to scription’s blood flow within the brain. Symptoms involve complex attention, information processing, planning and problem-solving. Changes and motivation personality or Mood also common often begin with atherosclerosis. And plaque thickens in Narrows artery walls reduce blood flow to her brain and other organs.

Question 21

Cardiovascular event

Answer 21

Pertaining to the heart and blood vessels such a stroke

Question 22

Atherosclerosis

Answer 22

Clocking of the arteries resulting from a buildup of plaque

Question 23

Plaque

Answer 23

Sticky material composed the fat cholesterol and other substances that builds up on the walls the veins or arteries

Question 24

Stroke

Answer 24

Sudden halt in the blood flow to a portion of the brain, leading to brain damage. Fourth leading causes of death in the United States. Particularly high for African-Americans. Cigarette smoking contributes to one in for strokes. 50% in younger people. Women who Smoke you have a 60-80higher risk of stroke, especially hemorrhagic strokes particularly high for women Who smoke. Depression associated with 34% increase in risk for stroke. Major cause of disability

Question 25

Hemorrhagic stroke

Answer 25

Stroke involving leakage of blood into the brain

Question 26

Ischemic stroke

Answer 26

Stroke due to reserve first blood flow supply caused by a clot or severe narrowing of the arteries supplying blood to the brain. 87% of strokes

Question 27

Transient ischemic attack TIA

Answer 27

A mini stroke or warning stroke resulting from a temporary blockage of blood vessels in the brain. Symptoms only last for a few minutes. Often preceded an ischemic stroke.

Question 28

Stroke symptoms

Answer 28

Slurred speech blurry vision or numbness on one side of the body. Women have unique stroke symptoms including some nausea, hiccups, facial pain overall weakness and shortness of breath. Left side strokes affect speech and language as well as physical movement and right side of body. Strokes on the right hemisphere can cause impulsivity and impaired judgment short term memory and motor movement on the left side of the body. Also on the right hemisphere stroke visual problems such as blurry or double vision

Question 29

Asymptomatic strokes

Answer 29

Symptoms of a stroke due to small bleach in the brain called micro bleeds or a decrease in blood flow from small clots or narrowed arteries can cause small pockets dead brain cells and lead to uneven deterioration in intellectual and physical abilities. Occur in 25% of older adults. Brain damage from small strokes cause 8 to 15% of all dementia, and often co-occurs with Alzheimer’s due to lifetime risk factors of hypertension diabetes and smoking increased both neurocognitive disorder vascular, and Alzheimer’s disease

Question 30

Neurocognitive disorder due to substance abuse

Answer 30

Substance abuse can result in delirium or more chronic bringing dysfunction. Symptoms are consistent with mild neurocognitive disorder and I are common in those with a history of Henry substance-abuse and those who continue using after age 50. Symptoms continue during initial absence but my improve with time

Question 31

Neurocognitive disorder due to Alzheimer’s disease

Answer 31

Dementia involving memory loss and other declines in cognitive and adaptive functioning. Most prevalent neurodegenerative disorder affects more than 5 million Americans. Risk increases significantly with age above 65 have a 1% risk those were 95 have a 40 to 50% risk. Prevalence and severity are greater among women than men

Question 32

Symptoms of Alzheimer’s disease

Answer 32

Impaired memory and learning develop quite gradually. Followed by a progressive decline in cognitive and behavioral function . Main feature is memory impairment. Early symptoms memory dysfunction irritability and cognitive impairment gradually worsened and other symptoms such as social withdrawal depression apathy delusions and impulsivebehaviors and neglect of personal hygiene often appear later. physiological indicators such as evidence of genetic mutations or brain changes are required to predict which patients with mild memory impairment will likely develop Alzheimer’s disease. May appear childlike or aggressive and combative. Initially may forget appointments phone numbers and addresses but as it progresses they lose track of the time of day, I have trouble remembering recent and past events, and forget who they are. A motions remain even when memory is gone.

Question 33

Brain changes with Alzheimer’s disease

Answer 33

End-stage have Mark shrinkage a brain tissue due to death of neurons. To abnormal structures Nuro fibrillary tangles and beta amyloid plaque. Both affect the table at processes and health of neurons and hippocampus and areas of the cortex associated with memory and cognition.

Question 34

Neurofibrillary tangles

Answer 34

Twisted fibers of tau, a proTien found inside the nerve cells of individuals with Alzheimer’s disease. Tau helps transport nutrients in healthy cells. With Alzheimer’s, Biochemical alterations in tau proteins result in cellular dysfunction

Question 35

Beta amyloid plaque

Answer 35

Clumps of beta amyloid proteins found in the spaces between neurons in individuals with Alzheimer’s disease. These and neural fibrillary teen girls are associated with decreased neurogenesis as well as information, loss of cellular connections, and other changes that eventually result in death of neurons and shrinking of the brain.

Question 36

Dementia with Lewy bodies

Answer 36

Second most common form of dementia results in cognitive decline combinedwith the development of unusual movements similar to Parkinson’s disease. Characteristics include :significant fluctuations and attention and alertness such as staring spells and periods of extreme drowsiness; recurrent, detailed visual hallucinations; and impaired mobility including frequent falls shuffling gait muscular rigidity and slow movement;and sleep disturbance including acting out dreams. Depression is,. Develops more rapidly than Alzheimer’s disease both have a similar survival period of about eight years after diagnosis

Question 37

Lewy bodies

Answer 37

Build up of abnormal proteins in the nuclei of neurons. Cell structures named after Frederick Lewy first discovered them they’re also present in Alzheimer’s. When they develop in the cortex they deplete acetylcholine resulting in perceptual, cognitive, and behavioral symptoms seen both in this dementia and later stages of Parkinson’s disease. They also cause the question of dopamine and motor dysfunction seen in Parkinson’s disease and later stages of dementia with Lewy bodies. Higher in men. Seems to be higher in some families.

Question 38

Frontal temporal lobar degeneration

Answer 38

Fourth leading cause of dementia. Progressive declines and language or behavior resulting from degeneration and atrophy in frontal and temporal lobe of her brain. Symptoms include: significant changes in behavior personality and social skills such as impulsive or uninhibited actions, the loss of empathy or apathy stereotype behavioral patterns or overeating; or progressive difficulty with fluent speech or word meaning such as understanding words are naming objects. Sometimes muscle weaknesses or motor abnormalities. Usually a minimal decline in learning memory or perceptual motor skill. Frontal lobe assoc with behavioral symptoms while temporal lobe with communication. Ave age 45-64, Second leading cause of early onset dementia. Appears genetic 40% with this report a family history of neurodegenerative illness.

Question 39

APOE gene

Answer 39

One variant to E4 version of peers to decreased production of a POE those increasing risk for Alzheimer’s disease contributes to 25% of Alzheimer’s disease.

Question 40

AutoZomal-dominant Alzheimer’s disease

Answer 40

Responsible for multi generational inheritance of early onset disease in some families causes Alzheimer’s disease to start in mid life as early as the 30s. These people produce cystic your version of beta amyloid protein that exits more slowly from the brain. One deterministic genetic variants TREM1 gene.

Question 41

Lifestyle variables associated with stroke and cardiovascular disease and Alzheimer’s

Answer 41

High fat diet results and increases in circulating beta amyloid and reductions of APOE,the chemical that helps clear the brain of beta amyloid by products. Older volunteers with poor sleep quality or quantity had more beta amyloid deposits. Beta-amyloid is cleared from the brain during sleep. Low levels of bad cholesterol and high levels of good cholesterol are associated with fewer amyloid deposits in the brain

Question 42

Neurocognitive disorder due to Parkinson’s disease

Answer 42

Parkinson’s disease involves for primary symptoms: tremor of the hands arms legs jaw or face; rigidity of the limbs and trumk; slowness in initiating movement; and drooping pasture or impaired balance and coordination. Motor symptoms of it in at least one year prior to cognitive decline. Later symptoms resemble dementia with Louis bodies. Personality and mood changes including apathy depressed Sharon Cytie as well as hallucinations and delusions can occur. Permanent damage to right hemisphere may have difficulty recognizing emotional cues especially face is conveying sadness. Can constrain interpersonal relationship. The second most neurodegerative disorder in US.

Question 43

Symptoms prevalence and causes of Parkinson’s disease.

Answer 43

Increases with age. 3% of those over 85. 630,000 Americans, will double by 2040.More men than women but reason unclear. Neurotransmitter dopamine is essential and the symptoms result from the accelerated aging of neurons and death of dopamine producing neurons in the mid brain as well as Lewy body proteins in the motor area of the brainstem. Only 5% are genetic. Occurs more in the Midwest and Northeast in an urban settings maybe due to environmental toxins

Question 44

Huntington’s disease

Answer 44

Genetically transmitted rare degenerative disorder characterized by involuntary movement twitching movements progressive dementia and emotional instability. Age of onset variable ranging from childhood to late life typically during midlife. Symptoms involve neurocognitive the client and changes in personality and emotional stability. Progressive cognitive deficits. Begin with difficulties of executive functioning involving complex attention planning and problem-solving. Become uncharacteristically apathetic moody and quarrelsome. Physical symptoms such as facial grimaces difficulty speaking in the prep repetitive movements often develop. Typically results in total dependency and need for full-time care there’s no treatment that’s the first 15 to 20 years after onset

Question 45

Constraint induced therapy

Answer 45

A form of rehabilitation therapy that encourages repeated in intensive use of the side of the body affected by brain damage by preventing use of the unaffected side find me such as putting the individuals good arm in the slaying helps prevent learn nonuse seen in those with brain damage

Question 46

Biological treatment in neurocognitive disorder’s

Answer 46

Medications vitamins and some conditions such as were next Korsakoff syndrome a disorder caused by thiamine be one deficiencies associated with chronic alcohol abuse. Higher levels of Homo Sistine are associated with increased risk of Alzheimer’s disease. Vitamins Bsix or B12 in decreased cognitive impairment in some individuals with high homocysteine levels. The vitamins reduce brain atrophy by 30% and up to 53% in those with highest levels of homocysteine. Vitamin E prescribing can also slow progression of Alzheimer’s disease. Deep brain stimulation and in planet electrons produced in a logical changes and symptom improvement. Gene therapy in Parkinson’s disease can help them modify brain cells to once again produce dopamine.

Question 47

Levodopa

Answer 47

A drug that increases dopamine availability can provide relief for both cognitive and physical symptoms of Parkinson’s disease.

Question 48

Two classes of drugs approve to help so the progression of Alzheimer’s disease

Answer 48

Acetylcholinesterase inhibitor’s and memantine approved to slow Alzheimer’s disease. No robust effects

Question 49

Rehabilitation and neurocognitive illnesses and environmental support.

Answer 49

Rehab is Very effective with the Acute conditions such as TBI or stroke. Neurodegenerative disorders such as dementia are irreversible and best managed by providing a supportive environment:make them feel happier and live comfortably with dignity. Bright light can improve sleep and decrease agitation and depression in dementia. Labeling family photos are writing answers to repeatedly asked questions can just cruise frustration resulting from memory difficulties. Family visits improve lives dementia because of emotional memories such as happiness that single one persist even when the visit itself is no longer recall

Question 50

Two major categories of sleep disorders

Answer 50

Dyssomnias and parasomnias

Question 51

Dyssomnias

Answer 51

Difficulties and falling asleep or maintaining sleep as well success of sleepiness during the day. These include insomnia disorder,hypersomnolence disorder, narcolepsy obstructive sleep apnea and circadian rhythm sleep wake disorder

Question 52

Insomnia disorder

Answer 52

Most prevalent sleep disorder involves distressing and disruptive pattern of chronic difficulty falling asleep or remaining asleep. Factors causing increased stress worry or anxiety. Excessive daytime sleepiness is a result and may impair cognitive functioning and alertness performance at work and enjoyment of activities. Many have comorbid physical or mental health additions. 50% of cancer patients experienceinsomnia. Highest in girls 11 to 12 years old and older adults and women.

Question 53

Hypersomnolence disorder

Answer 53

Condition involving difficulty waking up after sleeping and excessive daytime sleepiness, or prolonged on refreshing sleep. They sleep at least seven hours but me lapse into sleep I feel compelled to nap. Naps do not provide relief from sleepiness many experience sleep inertia.

Question 54

Sleep inertia

Answer 54

Significant grogginess and impaired alertness on awakening. Hypersomnolence is about 27.8% episodically. 1.5% have a disorder

Question 55

Narcolepsy

Answer 55

Where sleep disorder results in an irresistible or overwhelming need for sleep in the daytime even when adequate sleep occurs at night. Individuals often go immediately into REM sleep whereas a normal sleep cycle begins with 90 minutes of non-REM sleep. Many individuals experience cataplexy or the sudden loss of muscle function from very slight muscular weakness to complete physical collapse that can last for seconds or minutes. The person remains conscious during these episodes. Laughter or emotional states such as anger or fear can trigger cataplexy. Can be undiagnosed for years.

Question 56

Obstructive sleep apnea

Answer 56

The breathing related sleep disorder involving her or complete upper airway obstruction. While asleep those with this experience the collapse of the soft tissue in the rear of the throat resulting in partial or complete upper airway restriction. Results in significant daytime sleepiness. Obstruction repeatedly interferes with breathing during sleep resulting in snoring or gasping for breath excessive weight increases it. Can cause high blood pressure, cardiovascular disease and weight gain and is associated with increased risk of stroke. It’s associated with short telomere length suggesting this condition may accelerate cellular aging. Undiagnosed and 90% of women and 80% of men. Prevalence is from 3 to 7% and Man and 2 to 5% and women most prevalent in older adults

Question 57

Circadian rhythm sleep disorder

Answer 57

Pattern of recurrent sleep disturbance caused by a disrupted biological sleep wake cycle or a mismatch between environmental demands in a person’s internal clock

Question 58

Parasomnias

Answer 58

Involve a unusual behaviors or events occurring during sleep or in sleep-wake transition. Physiological systems associated with sleep do not function normally. Include non-rapid eye movement sleep arousal disorder’s, nightmare disorder, and rapid eye movement sleep behavior disorder

Question 59

Non-REM sleep arousal disorder’s

Answer 59

Involve simultaneous wakefulness and NREM sleep. Episodes of incomplete arousal which involve talking or motor activity with eyes open but minimal conscious awareness occur early in the night,last no more than 10 minutes. Little or no memory the next day or two types: sleep terrors and sleepwalking.

Question 60

Sleep terrors

Answer 60

Abrupt episodes of intense fear including sweating rapid breathing or increased heart rate that occur growing sleep. Often people crown panic but are not fully aroused. Become more agitated if awakened.About one third of young children experience this.

Question 61

Sleepwalking

Answer 61

In love sitting up and walking during sleep. Person usually has blank stare, does not respond I’ve spoken to and is not easily awakened. Occurs in a state of reduced alertness and involves behaviors requiring a little complexity. Some people eat or engage in sexual activity or unusual behavior such as urinating in appropriate places without conscious awareness. 29.2% of adults reported occasional 5% of adults have to stress and impairment. Usually disappears during early adolescence. Adults havechronic waxing and waning course.

Question 62

Nightmare disorder

Answer 62

Condition involving frightening dreams that produce awakening. Often involve threats to survival or sense of security. Story like episodes occur almost exclusively during REM sleep. Fear and in Anxiety associated with the nightmare because the person become alert and distress. often makes it difficult to resume sleeping. Most common during adolescence and young adult hood more prevalent in females. 1 to 2% of adults. 18% and individuals with depression schizophrenia and insomnia and up to 50% are over in those with PTSD and borderline personality disorder

Question 63

REM sleep behavior disorder

Answer 63

Involving dream related for stations in motor behavior that occurred during REM sleep often of a violent nature. The movement of speaking is associated with the content of a persons dreams. Sometimes people scream and hit or injured or sleeping partner. Once a week on posting this on work and orientated. Potentially dangerous this more prevalent among middle-aged and older males

Question 64

Causes of sleep wake disorders

Answer 64

Does Samius tend to be associated with lifestyle and psychological factors including: interest of uncontrollable thoughts associated with stress worry anxiety depression and preoccupation with sleep and to stress over sleep difficulties, lifestyle factors such as your regular schedules resulting from shiftwork retirement napping Cetra, nocturnal activities that interfere withsleep such as heavy eating and exercise, medical condition such as congestive heart failure or stroke, drug or alcohol abuse or psychiatric conditions especially depression PTSD and in Zaidi disorder. Many withsleep disorders ,esp. parasomnias have family members with sleep difficulties. The genetic predisposition to physiological arousal and coupled with preoccupations getting enough sleep and stress one on able to sleep can create a vicious cycle that results in insomnia and the disruption of normal sleep pattern. Less is known about cause with parasomnias. sParasomnias often remit spontaneously.

Question 65

Treatment of sleep wake disorders

Answer 65

For insomnia includes maintaining regular sleep wake schedule, exercising but early in the day, avoiding caffeine long naps having meals alcohol or nicotine within two hours of sleep, relaxing before going to bed and mindfulness techniques, minimizing worry about sleep avoiding clock watching, and illuminating distractions and competing behaviors from the bedroom. CBT is effective for insomnia. For apnea use a continuous positive airway pressure therapy sleep on the side lose weight avoid alcohol. Medications that maintain alertness for excessive sleepiness and narcolepsy sleep apnea and sleepiness due to shift work. Sodium oxybate can help control cataplexy. Clonazepam and melatonin sometimes successful in reducing aggressive movement in REM sleep behavior disorder. Sleep inducing medication such as zolipedem, sonata and Lunesta are used to treat insomnia. May remain in effect after awakening resulting in motor in coordination cognitive confusion and trafficaccidents. Antidepressants are also used.